Red flags: rare or absent bruise occurrences resulting from a single injury incident*
| Bruise characteristics concerning for abuse | Unintentional injury history examples | Bruise or incident rare or low occurrence rates6 |
| Posterior surface (torso, buttocks and legs)3 5 | Most involved fall and hitting or impacting object | 5% (35/693 bruises) |
| Linear pattern of bruising4 | Fall on edge of furniture/frame | 0.9% (5/559) incidents |
| Multiple (four or five) bruises from single incident3 | Stair fall >10 steps, sports, motor vehicle crash | 0.9% (5/559) incidents |
| Bruising to front and back of body from single incident | Hit by car; fall down 12 steps | 0.3% (2/559) incidents |
| Petechial bruising4 | High velocity—fall off horse | 0.3% (1/293)† bruises |
| Ear, neck or genital bruise3–5 | Did not occur | 0% (0/693) bruises |
| More than five bruises3–5 | Did not occur | 0% (00/559) incidents |
- ↵*Presence of these bruise characteristics raises a red flag, and injury plausibility should be assessed with caution. Hibberd et al identified no or low rates of occurrence for the following bruise characteristics in this unintentionally injured cohort, adding compelling evidence to the red flag nature of such findings.6
- †Only cases enrolled from the emergency department were evaluated for petechia.
No comments:
Post a Comment